Kaiser Permanente San Diego has rescheduled an unspecified number of non-urgent mental health appointments this week due to a five-day statewide strike over a range of issues from staffing and resource management to pay and benefits.

Though its San Diego-area hospital emergency rooms remained open to handle urgent psychiatric illnesses, Jennifer Dailard, a spokeswoman for Kaiser San Diego, said in an email that the strike made it necessary to pull back on office-based care.

“We began contacting all members that needed to be rescheduled to offer them an appointment the week before or after the strike period or an option to have an appointment with a community mental health provider,” Dailard said.

Kaiser did not say exactly how many appointments were rescheduled.

Picketers who gathered Monday at Ruffin Road and Clairemont Mesa Boulevard in front of Kaiser’s new San Diego Medical Center were members of the National Union of Healthcare Workers, which represents Kaiser marriage and family therapists, licensed clinical social workers, psychologists and psychiatric registered nurses.

It’s not the first time the union has gone on strike over Kaiser’s approach to mental health. In 2015, the same group walked picket lines in front of Kaiser’s Zion Avenue hospital citing understaffing that drew a $4 million fine from the state Department of Managed Care in 2013. That fine came amid what the state said were problems with Kaiser members getting timely initial mental health appointments.

Mark Land-Ariizumi, a psychiatric nurse at Kaiser’s Point Loma medical office complex, said that while the Kaiser system has managed to make sure that initial mental health appointments are made in a timely manner, it can take “six to eight weeks” for follow-up appointments. That wait, he said, exceeds the standard of care.

“Evidence-based practice shows you need more frequent and regular visits to get to the point where you can sustain recovery from conditions like depression and anxiety,” Land-Ariizumi said.

But Kaiser, in its own emailed statement, disagreed with the picture that the union is painting about follow-up appointments.

“The timing of follow-up appointments is based on each patient’s treatment plan and created by their therapist. We audit patients’ charts to make sure this plan is being carried out, and have found that for the vast majority of patients, return visits occur within the appropriate time frame up to 94 percent of the time,” the statement said.

Kaiser also pushed back against the strike stating that it has increased psychiatric staffing by 30 percent since 2015 and has added 500 new therapists statewide, investing $175 million to expand office space and insisting that it pays the best wages in the state for this type of work. Base pay is $135,000 per year for psychologists and $109,000 per year for social workers, Kaiser said.

The union’s contract with Kaiser lapsed in October, allowing its members to strike.

Though picketers on the street focused entirely on a message of patient care, it is clear that strike leverage is also being used on wage increases. Land-Ariizumi said other similar bargaining units have received pay increases of 2.75 percent to 3 percent per year while NUHW’s bargaining unit has been offered only a 1.5 percent pay increase per year. Pensions, he added, were eliminated for anyone hired after 2015 in the bargaining session for the union’s previous contract.

"We're not asking for anything more than what is already being done. We're asking to be treated fairly and equally," Land-Ariizumi said.

In addition to San Diego, the strike is scheduled to continue through Friday at Kaiser facilities in Los Angeles, Anaheim, Fontana, Fresno, Sacramento, San Francisco and San Jose.

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